Research progress on moderate and deep sedation during wound dressing change in pediatric burn patients / 中华烧伤杂志

Moderate and deep sedation can effectively relieve or eliminate the pain and body discomfort during wound dressing change in pediatric burn patients, relieve anxiety, agitation, and even delirium of the children, reduce the metabolic rate of the children, make them in a quiet, comfortable, and cooperative state, which is conducive to the smooth completion of dressing change. This paper summarized the three aspects of moderate and deep sedation in pediatric burn patients, including the overview, main points of implementation, and effects, and further introduced the moderate and deep sedation medication regimens for different routes of administration, as well as the content of evaluation and monitoring. Suggestions on the prevention and management of related complications and the management of moderate and deep sedation implementation procedures were put forward, in order to provide references for the development of moderate and deep sedation for wound dressing change in pediatric burn patients in China.

Associations of Serum Irisin Level With Brachial Ankle Pulse Wave Velocity and Ankle Brachial Index in Hospitalized Patients / 中国循环杂志

Objectives:To investigate the association between serum Irisin and brachial ankle pulse wave velocity (Ba-PWV) and ankle brachial index (ABI) in hospitalized adult patients. Methods: A total of 147 patients hospitalized in Fuwai Hospital were enrolled in this study. Patients with acute cerebral haemorrhage and cerebral infarction, acute myocardial infarction, hepatic and renal dysfunction as well as malignant tumor and hematopoietic disorders were excluded. Ba-PWV, brachial systolic pressure and ankle systolic pressure were measured by Complior device. Then ABI was calculated. Serum Irisin level was determined with ELISA kit. The recruited subjects were allocated to 2 groups based on Ba-PWV: high Ba-PWV group (Ba-PWV≥1 400 cm/s, n=93) and low Ba-PWV group (Ba-PWV<1 400 cm/s, n=54). According to ABI, the participants were also divided into 2 groups: low ABI group (ABI<0.9, n=31) and high ABI group (ABI≥0.9, n=116). Results: Patients in high Ba-PWV group were older, (P=0.035), had higher prevalence of hypertension (P=0.006), higher ESR (P=0.02), higher fast glucose (P=0.002) and lower serum Irisin level (P=0.007). Multiple stepwise regression analysis showed that serum Irisin was independently related to Ba-PWV (β=-0.559,P=0.003,OR=0.572 (0.394-0.831) . Patients in low ABI group were older (P=0.005), had higher LDL-C (P=0.004), higher total cholesterol (P=0.002), higher fast glucose (P=0.007), higher apolipoprotein B (P=0.030), less smoker (P=0.045), and lower serum Irisin level (P=0.014). Multiple stepwise regression analysis showed that serum Irisin was independently related to low ABI (β=-0.734, P=0.035, OR=0.480 (0.243-0.949). Conclusions The serum Irisin level is related with arterial stiffness and peripheral arterial atherosclerosis in this patient cohort.

Relationship Between Soluble ST2, Galectin-3 and Clinical Prognosis of Ventricular Septal Myectomy in Patients With Obstructive Hypertrophic Cardiomyopathy / 中国循环杂志

Objective: To explore the relationship between plasma levels of soluble ST2 (sST2), galectin-3 (Gal-3) and clinical prognosis of ventricular septal myectomy in patients with obstructive hypertrophic cardiomyopathy (HOCM). Methods: A total of 200 consecutive HOCM patients received modified Morrow surgery in our hospital from 2011-03 to 2016-02 were studied. According to plasma levels of sST2, patients were divided into 3 groups: Low sST2 group (sST2<9.05 ng/ml), Middle sST2 group (sST2 9.05-16.74 ng/ml) and High sST2 group (sST2>16.74 ng/ml); based on plasma levels of Gal-3, patients were divided into another 3 groups: Low Gal-3 group (Gal-3<6.19 ng/ml), Middle group (Gal-3 6.19-8.22 ng/ml) and High Gal-3 group (Gal-3>8.22 ng/ml); in addition, Control group, n=42 volunteers without heart disease. Plasma levels of sST2 and Gal-3 were measured by ELISA, compared between Control group and HOCM group (n=42 patients with matched gender and age to Control group). The predictive value of sST2 and Gal-3 on major endpoint events including all cause death or cardiovascular hospitalization were assessed by Cox regression analysis.Results: Compared with Control group, plasma levels of sST2 and Gal-3 were increased in HOCM patients, P<0.01. The patients were followed-up for the average of 26 months, Kaplan-meier survival analysis showed that the incidences of composite endpoint event were similar at different levels of sST2 and Gal-3 (log-rank P=0.06 and P=0.68). Cox regression analysis indicated that either sST2 or Gal-3 could not independently predict the endpoint events, both P>0.05, while age was an independent risk factor for composite endpoint event occurrence (HR=1.06, 95% CI 1.02-1.11, P<0.01). Conclusion: Plasma levels of sST2 and Gal-3 were not related to clinical prognosis of ventricular septal myectomy in HOCM patients even they had increased sST2 and Gal-3; while advanced age was the independent predictor for endpoint event occurrence.